HomeMy WebLinkAboutPermit Mechanical 2009-1-9
Status
Issued
CITY OF SrKlr"lGFIELD
Building/Combination Permit
. PERMIT NO: ~OM2099-00033
ISSUED: 01/09/2009
APPLIED: 01/0912009
EXPIRES: 07/09/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 6560 THURSTON RD
ASSESSOR'S PARCEL NO.: 1702341200205
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Mini split installation
Owner: SWEENEY MICHAEL N & LAURIE J
Address: 6560 THURSTON RD
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION I.
Contractor Type
Electrical
Mechanical
Contractor License
OWNER
EUGENE HEATING & COOLING 149452
BUILDING INFORMATIONJ
Expiration Date Phone
10/22/2009 541-726-7654
# of Units:
Primary Occnpancy Group:
Secondary Occupancy Group:
Primary Coustruction Type
Secoudary Construction Type:
# of Bedrooms:
# of St~ries:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Euergy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
'. DEVELOPMENT INFORMATION 1
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PTTr-t\ITlnf\l' nrp(lr1n I;lW n::~mJirp'r:; \r()JJ tQ
I PUBLIC IMPROVEMENTS,.lles adopted by the Oregon Utility
. ': _ ::.; _ uu on Center. Those rules are setforth
Street Improvements: in OAR 952-01SId~~a!Mlixp,ejh OAR 952-001-
St S A'I ~'nT1CE' ' 0090, You maD" obtain CtQ,r.lD;8S .of the rules by
orm ewer val a e:~ . . . ' ownsp9:u s r.ams:
S . I I t f HIS P calling the cemer. (Nore: Ine releohone
peCIa ns ruc IOn:AUTHO ERMIT SHALL EXPIRE IF T number for the Oregon Utility Notiiication
N CO RilED UNDeR THIS P HE WORK Center is 1-800-332-2344),
otes: MMENC, E.o~, ~ ERMIT IS NOT
ANY '80 DA0~fO FDR
~0:'
Paee 1 of 3
_'Ill~"~RFil!~I
,
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Description
Tvpe of Construction
Fee Description
+ 12% State Snrcharge
+ 12% State Surcharge
+ 5% Technology Fee
+ 5% Technology Fee ,
Add, Alter, Extend Circ Ea Add
Air Handling Unit Up to 10,000
Heat Pump
Minimum/Adjustment Mechanical
Perm Serv/Fdr 200 amps or less
Total Amount Paid
I Valuation Oes~~iDtion'
$PerSq Ft
or multiplier
Square Footage
or Bid Amount
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00033
ISSUED: 01/09/2009
APPLIED: 01/0912009
EXPIRES: 07/09/2009
VALUE:
Value
Date Calculated
Total Value of Project
FpP~. pqWJ
Amount Paid
Date Paid
Receipt Number
2200900000000000028
2200900000000000031
2200900000000000028
2200900000000000031
2200900000000000031
2200900000000000028
2200900000000000028
2200900000000000028
2200900000000000031
To Request an inspection call the, 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day. '
$9.48
$11.16
$3,95
$4,65
$12.00
$17.00
$17,00
$45,00
$8'1.00
1/9/09
1/9/09
1/9/09
1/9/09
1/9/09
1/9/09
1/9/09
1/9/09
1/9/09
$201.24
I Plan Reviews I
I R~nllirprl Jn~nprt&l
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete,
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete,
Paee 2 of3
225 Fifth Street. Springfield, OR 97477HH(541)726-3753+FAX(541)726-3689
,
1;~1'iitDEP:&;Rl1MENTtlISEIO~y:,:j~~1
;rph;rJji~;,t~l',,.~i,''!(~~'''ri*kgf':i,\:~*~;t;1i:.~
I Permit no,:t,aIY\L()'.)'1 ---00 ok >-
I I' ~C,1-- eJ') I
Date:
Electrical Permit Application
This permit is issued under OAR 918-309-0000, Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
~iiil^~I!0:C:<<l!iG'QVEBNnnENiT'~ReR0V.6;~_ ~~~~~~"iIiEI;1iscf;!ED.t!l!E' I
I Zoning approval verified? 0 Yes 0 No - l'tOial~1
Il!IIl,,~~1(G~l1EGORY~.!:5fiIG0N~T(RI.iJ.GjliI0N~~~1 ;.:ml.m~,.,
I Residential, per unit, service ~ncluded: I
IMResidential I 0 Government ' I 0 Commercial
I~Qi3lsl;r;EilINIi0B.M:<<\J!JQN~AN[j:rrfI!c;rG'MjI0N~~ 11,000 sq. ft. Or less (4) $134.00 $ I
I '1 Each additional 500 sq, ft, or portion I
Job site address: (€,54oO 7kv,.--:5 -/-oN ~d, thereof $ 25.00 $
I City: 5r/A.J).PrelJ, I State: ()r<, I ZIP: f7Cf1'i I I Limited energy (2) $ 32.00 $ I
1~~~S~~~~~R~~'~N~~W:;~:::Ti I ::~:::::~;~::re~:s~~::;:~:C::::ratjnn, reln:at::~OO $ I
(, Nt C' /. f- I I I 200 amps or less (2) \ $ 81.00 $ 21. o~
_ '+rJr /11;"'; --.JfJlif /ileA; iJu/l1.-{j I
~~'lii'l:;~il"'~RRQ""ER.'I1Y;i[OWJllER~Wl\t~~~~f;'i;;~1 1201 to 400 amps (2) ~j $ 95.00 $ I
I Name: 10'c-/trU./ "'f'--L,twr/e.. SWe.R-fJV-j I I 401 to 600 amps (2) / $158.00 $ I
I Address: fo6~,O 7hW5/vIU I<d. I I 601 to 1,000 amps (2) $205.00 $ I
I City:5,a-!'--IJ I State: i>>< I ZIP: 97L/7g' I I Over 1,000 amps or volts (2) $469.00 $ I
I Phone1fQJ-1I1- C;oofl Fax: I I Reconnect only (2) $ 63.00 $ I
I E-mail: I I Temporary serv'ices o'r feeders: installation, alteration, relocation I
This installation is being made on residential or farm property I 200 amps or less (2) $ 63.00 $ I
owned by me or a member of my immediate family. This I 201 to 400 amp"(2) $ 87.00 $ I
property is not intended for sale, excnange, lease, or rent OAR
479.540(1) and 479.560(1). I 401 to_~Q."IO'Ps (2) $126.00 $ I
Signatu!e0L--J~~' I OV1(9R~.~~pAg[:'t<iqQ.~RJts, s'~e.serv~ces orfeeqers section above I
1~==:::~NmM(:mQW~INsmp.:~l!A'mGN-'~f~t~~i I :r;;~;::~~~~~;~~;~~~,:~~:r:~~:"~~n:'::,::~rlfeeder fee I
Address: . I I E~2h'"'bran~hla~~~tit VU~~111 \"~}J;,c',~ \.11 li it: I' u'f~6\OO I I
L..(./,"ll\j "''''' \...l1tP.L (f'\!(,t(.l the toloF,h,,,~,,' $
I City: I State: / ZIP: I b. F)leJfoiQra?ch"d.ir,c.uit$~~~h_o.~HP'I}.~~rl~~gL~;~e.rrJinor feeder fee: I
I Phone: I Fax: I First brancii'W~tflt (2) ,-tiUU-;;S;;S"-,,, ~ _ $ 55.00 $ I
I E-mail: I Each additional branch circuit. Z-- $ 6.00 $/l. ~
I CCB license no.: I BCD license no.: I Mis~ellaneous fees: service or feeder not included I
I Signing supervisor's license no.: I Each pump or irrigation circle (2) $ 63.00 $ I
I 'Print name of signing supervisor: I Each sign or outline lighting (2) $ 63.00 $ I
1 Signature of signing supervisor: I Signal circuit or a limited-energy panel, I $ 63.00 $ I
alteration, ,?f extension (2)
1==~~,S~~~tiO'~:;_(;),~''',','_'lIfL__, -=~~ '-, .1
~,___.;w,,-~AP'RI1IGANiT'll>8.SE~'fuIl!!_!~ .~iiiiil
(A) Enter subtotal of above fees I
(Minimum Permit Fee $58.00) $
I (B) Enter 12% surcharge (.12 x [AD I $ I
I (C) TechilOlogy Fee (5% of[AD $ I
I TOTAL rees and surcharges (A through C): $ /08 r S' / I
NOTICE:
THIS PERMIT SH '
~UTl-IORIZED UN~LL EXPIRE IF Tl-iE WORK
COMMENCED OR I~~ THIS PERMIT IS NOT
ANY 180 DA\' PE I BANDONED FOR
. R~D I
. .
440-2584-J (9/08/COM)
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00033
ISSUED: 01/0912009
APPLIED: 01/09/2009
EXPIRES: 07/09/2009
VALUE:
By signatnre, I state and agree, that I have carefully examined the completed applicatiou aud do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety,
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensnre that all required inspections are requested at the proper 'time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Paee 3 of 3
Date
o .' G~-~OO~?
Construction Conttactors Board ~ . Permit#:'. / Y , -=> '. ,.
700Surnrner St NE Suite ~OO Adm:ss:-.&ft:"=:>0' :?J;; / ~j6r--, '
_ PO Box 14140 ." " '" .:., ~ - -' ,
i' .! Salem OR 97399.5052 . . ',:., Iss.;eaOY://"~/..</\' '" . ~ate: /___ 'J".-- 0 '7
'" ." Phone:. 503-378.4621 " / (I '
, ".. ..... . Web Address: WWW.CCb;state:or.~s.. ,_ '. ',.:. /
statement: Information Noti~e to-Property Owne~s
, About Construction Responsibilities
-\
"
.r ."
.
Note: Oregon Law, ORS 701,055(4)'requires residential construction permit applicants who are not
licensed with the ConstruCtion Con!ractors Board fa sign the following statement before a building
permit'can be issued. This'statement is requiredforresidential building, electrical, mechanical and
plumbing permits. Licensed architect and engineer applicants, eiempt from licensing under
. ORS701:010(7), need not submit this statement,. ,This statement will be filed with the permit.
. '. . . . . .
Fill in the app.vp.:ate bl3nks and initial boxes 1 and 2, and'~itlie! box 3A or.3B:.
, . ~, ~. . I own, reside in, or will reside in the completed structure.
... .".
. 0 2. J I understand that! must become licensed as a construction contractor'ifthe structure is sold or
. offered for sale before or on' completion.'.-. ,.
'It, '3A. My g:ne~al contracto~ is/1tUi.tH-( iV'5~UlVeq
,,' VI . . . (Name) / (CCB#)
~V~ .
, . . I will instruct my general contractor that all subcontractors who~ork on.the structure musrbe
licensed with the Con'struction Contractors Board_ ,. -
OR
~ 3B. I will be my own general contractor. 6\~\~'
If! hire subcontractors, I will hire only subcontractors licensed with,the Construction Contractors'
Board. ,If! change my mind and hire a general contra9tor,-,1 will contract with a co~!J:actor who is, .
licensed with the CCB and will immediately notify:the.office issuing this building permit of the
name of the contractor.
-.
"
. - ... ,
I hereby certify that ttie above information is correct and that I have read and do understand the Information '
Notice toPropert): Owner~aboutConstruction Responsibilities ontpe reverse side oftbis form,
cX~'~ ;11j()'9
(Signature otE)rmit applicant) I (Date)
;.,;. (Whi~e c.opy to issuing agency permit file, pink copy to. applicant.)
" .
Pro~erty~owner.doc 06~Ol-04
'0
~. '.
. ,."
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Offi~ial Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2009-00033
COM2009-00033
COM2009-00033
COM2009-00033
Payments:
Type of Payment
. Check
cRcceint I
RECEIPT #:
2200900000000000031
Date: 0110912009
Description
Penn Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
MICHAEL N SWEENEY
Item Total:
Check Number Authorization
Received.By Batch Number Number How Received
njm 3526 In Person
Payment Total:
Page I of I
10:40:49AM
Amount Due
81.00
12.00
4.65
11.16
$108.81
Amount Paid
$108,81
$108.81
1/9/2009